Department of Health silence over failure to highlight ESA suicide risk

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The Department of Health (DH) has refused to say why it failed to warn NHS bodies and other local services that claimants of out-of-work disability benefits are at a hugely-increased risk of attempting to take their own lives.

DH published the latest version of its national suicide prevention strategy in January this year.

The strategy was published four months after NHS Digital produced the results of its Adult Psychiatric Morbidity Survey (APMS), which showed that more than 43 per cent of claimants of employment and support allowance (ESA) had said (when asked in 2014) that they had attempted suicide at some point in their lives.

But the suicide prevention strategy fails to mention these figures or to highlight ESA claimants as a high-risk group, even though it briefly mentions Department for Work and Pensions (DWP) guidance for dealing with ESA claimants who may be at risk of suicide or self-harm.

This week, a DH spokeswoman refused to explain why the figures were not mentioned in the strategy or why ESA claimants were not highlighted as a group at particularly high risk of suicide.

Instead, she said: “As I know you’ve discussed with the DWP, suicide is a very complex issue, so it would be wrong to link it solely to anyone’s benefit claim.

“There is clear guidance in place for DWP staff members to follow if a claimant expresses a desire to self-harm, to ensure the claimant receives appropriate care and support.

“We updated the National Suicide Prevention Strategy to strengthen delivery of its key areas for action to reduce suicides. 

“This includes ensuring that every local area has a suicide prevention plan in place by the end of the year to ensure that all local services are working together to implement tailored approaches to reducing suicide in their communities. 

“Good suicide prevention plans include action to address the wider determinants of suicide risk including unemployment and living with long-term conditions or disabilities.”

The DH refusal to explain its failure to highlight ESA claimants in its suicide prevention strategy comes as Disability News Service this week publishes new figures (see separate story) which show that the proportion of people claiming the main out-of-work disability benefit who have attempted suicide doubled between 2007 and 2014.

The figures show that in 2007 – a year before the introduction of the much-criticised work capability assessment, which tests eligibility for ESA – 21 per cent of incapacity benefit (IB) claimants told researchers they had attempted suicide at some point in their lives.

IB began to be replaced by ESA under the New Labour government the following year, in 2008.

But by 2014, following four years of social security reforms under the new coalition government, and austerity-related cuts to disability benefits and services – and six years of the WCA – more than 43 per cent of ESA claimants were saying they had attempted suicide.

The figures were calculated for DNS by Sally McManus, who leads research on the survey for the independent social research institute NatCen, on behalf of NHS Digital.

It is unclear if the government has ever made the same calculation, and if it has, why these figures have never been published.

But the DH failure is just the latest evidence that the government has ignored, and even covered up, links between its efforts to force people with mental health conditions into work, and increased levels of suicide, attempted suicide, suicidal thoughts and self-harm.

Letters written by coroners, which blamed the WCA process for triggering two suicides and called for changes to the assessment process, were ignored by ministers.

They also failed to pass the first of those letters, written in April 2010, to the independent expert who was reviewing the WCA, Professor Malcolm Harrington.

Ministers also failed to pass on the results of internal reviews into the deaths of ESA claimants that were linked to the WCA to Professor Harrington.

As a result of these failures to act to improve the WCA, many other claimants are believed to have died, including Mark Wood, Paul Donnachie, David Barr, and a woman known only as Ms D E.

The strongest evidence until now that there was a link between the WCA and an increase in mental distress came in November 2015, when public health experts from the Universities of Liverpool and Oxford showed in a study that, for every 10,000 IB claimants in England who were reassessed for ESA between 2010 and 2013, there were an additional six suicides, 2,700 cases of self-reported mental health problems, and an increase of more than 7,000 in the number of anti-depressants prescribed.

In all, across England, the reassessment process from 2010 to 2013 was “associated with” an extra 590 suicides, 279,000 additional cases of self-reported mental health problems, and the prescribing of a further 725,000 anti-depressants.

DWP dismissed the findings of that report in 2015 and said it was “wholly misleading”.

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Pictured: The Department of Health’s Whitehall offices